Background: Particulated juvenile cartilage allograft transfer (PJCAT) is an emerging treatment option for management of osteochondral lesions of the talus (OCLTs). This series reports on outcomes and identifies predictors for success following PJCAT for isolated OCLTs. Methods: We reviewed 33 consecutive patients who underwent PJCAT by a single surgeon from 2013 to 2017. Preoperative demographic factors (age, body mass index [BMI], tobacco use, behavioral health comorbidity, and ankle pain visual analog score [VAS]) and OCLT morphologic data were collected. Outcomes included postoperative improvements in VAS and American Orthopaedic Foot & Ankle Society (AOFAS) score and clinical success/failure. Results of 7 second-look arthroscopies and complications are provided. Categorical data are reported as frequencies, and statistical means with P values are reported for continuous variables. We had a mean 3.5 years of follow-up. Results: Improvement in ankle pain VAS following isolated PJCAT was 51% ( P < .001). For the first 16 consecutive patients in whom complete AOFAS scores were available, 40% ( P < .001) improvement occurred. Presence of 1 or more behavioral health diagnoses was a risk factor for decreased pain relief, while moderate to severe preoperative pain (VAS >5.9) predicted improved postoperative pain relief. Age, BMI, tobacco use, and OCLT morphology did not affect outcomes. Conclusion: For treatment of large, high-stage OCLTs, PJCAT resulted in 40% to 50% improvement in ankle pain and disability within 3.5 years. The results may be better in patients with moderate to severe preoperative pain but worse in those with preexisting behavioral health diagnoses. Level of Evidence: Level IV, retrospective case series.

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Objectives: The purpose of this study is to establish a consensus estimate of operating room cost per minute based on currently published literature. Design: Literature review. Main outcome measurement: Operating room cost per unit time. Results and conclusions: Google Scholar search produced 51 articles regarding ““operating room cost per minute” of which 14 had novel estimates for OR cost per minute. The mean of these estimates was $46.04 ± $32.31. There was little consistency in methodology among the included articles, which is reflected in the large range of values. Level of Evidence: IV; Review Keywords: Business, management, human resources, cost, value, efficiency. (J Ortho Business 2022; Volume 2, Issue 4: Pages)

Objectives: Provide a framework for the development of a “Code Femur” protocol for geriatric distal femur fractures. Design: Literature Review and Evidence Based Note Templates Intervention: Distal Femur Fracture Fixation and Medical Management Main Outcome Measurement: Post operative Mortality Results: Geriatric distal femur fractures are rising in number among osteoporotic fractures in the growing elderly population. Current hip fracture literature recommends fixation of proximal femur fractures in 24-48 hours to reduce mortality and the literature surrounding distal femur fractures in this population in trending in this direction as well. The goals of distal femur fracture surgery are early mobilization and fracture stabilization in addition to managing the multiple medical co-morbidities that these patients may have. This review discusses the treatment options available for geriatric distal femur fractures that allow for early mobilization and examines the benefits of early operative care. Conclusion: Geriatric Distal Femur Fractures present similar challenges to management as the geriatric hip fracture and a proper understanding of medical co-management and early appropriate surgery through the development of a distal femur fracture program similar to hip benefits warrants consideration. Level of Evidence: Level IV, Systematic Review Keywords: Code Femur, Geriatric, Distal Femur Fracture, Post-operative Mortality, Co-Morbidity